Neonatal Jaundice Bilirubin Risk Nomogram
Determines phototherapy and exchange transfusion thresholds for neonatal hyperbilirubinemia based on AAP 2004 or 2022 guidelines.
Total serum bilirubin level
Postnatal age in hours
Gestational age at birth in completed weeks
Risk factors that lower treatment thresholds
AAP guideline version for threshold calculation
⚠️ Warnings & Contraindications
- AAP 2022 raised phototherapy thresholds for healthy term infants compared to 2004
- Universal bilirubin screening recommended before discharge for infants >=35 weeks
- Transcutaneous bilirubin (TcB) can be used for screening; confirm elevated TcB with serum TSB
- Infants <35 weeks gestation have lower thresholds
- Rapidly rising bilirubin (>0.3 mg/dL/hour or >5 mg/dL in 24 hours) requires urgent evaluation
- Use hour-specific nomogram, not day-specific
ℹ️ Clinical Notes
The AAP 2022 guideline eliminated race as a risk factor, recommends universal screening, and uses gestational age separate from neurotoxicity risk factors. The Bhutani nomogram (2004) hour-specific percentile curves are commonly used.
References
- AAP 2022 Clinical Practice Guideline - Management of Hyperbilirubinemia - Pediatrics (2022)
- Impact of the 2022 AAP guideline on phototherapy use - PMC (2024)
- AAP 2004 Hyperbilirubinemia Management Guideline - Pediatrics (2004)
Medical Disclaimer
This calculator is provided for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or calculated using this tool.
The authors and publishers of this calculator make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability of the information, products, services, or related graphics contained within this tool for any purpose.